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Hydroxychloroquine and COVID-19: What we know so far

Written by : Dr Nimeshika Jayachandran

Long before the coronavirus received so much attention, hydroxychloroquine (HCQ) had been used by doctors to treat rheumatoid arthritis and lupus. It was also prescribed for malaria. A new study has shed some light into the use of the drug HCQ in treating those with COVID-19. While experts remain headlocked in a debate about the efficacy of HCQ in treating the coronavirus disease, there remains a lot of questions about the drug itself. What is HCQ and what do you need to know about it? TNM brings you the basics.

The drug was first thrown into the limelight after a French study indicated that HCQ in combination with azithromycin, an antibiotic played a significant role in decreasing the viral load (concentration of virus in the blood) of an infected individual. However, the scientific community has been divided over this, as the study which was a clinical trial was based on a small number of patients. The French study was used by many to proclaim HCQ as a “wonder” drug.

“It was around World War 2 that scientists first began using HCQ to treat patients who had been diagnosed with malaria. Prior to that, a precursor of the drug was being used which had several unpleasant and potentially toxic side effects. It was eventually found to be effective in treating individuals with lupus and rheumatoid arthritis,” states Bengaluru-based pharmacologist Dr Annapurna. 

She explains that in both lupus and rheumatoid arthritis, the immune system is affected and begins attacking the body’s own cells.

“In simple terms, HCQ was found to be effective in controlling the way the immune system responded in these conditions,” says Dr Annapurna.  

What the US study says

US President Donald Trump has been extremely vocal about his stance on the use of the drug to treat COVID-19 affected individuals. However, as per a study published on April 21 which has been conducted at the US Veterans Health Administration, the drug may actually be more harmful than beneficial.

Of 368 patients who were observed in the study, 97 individuals took HCQ. A 27.8% death rate was observed in this group. Of the 158 individuals who did not take the drug, 11.4% was the reported death rate. The study also reported that eight individuals had to be taken off the drug because of changes in their heart rhythm, which is a known side effect of the drug. 

The researchers also looked to see if HCQ administered along with the antibiotic azithromycin would play a role in whether someone required ventilatory support or not. They found that the addition of the antibiotic or withholding it, did not have a significant effect on determining whether someone required the ventilator or not. 

“This is a drug that still has to be studied, we know so little about how it can impact someone who has been diagnosed with COVID-19. Even this research has yet to be reviewed,” adds Dr Annapurna. 

The Indian Council of Medical Research (ICMR) had stated that HCQ could be given to ‘high-risk’ individuals as a precautionary measure. High risk individuals have been identified as asymptomatic healthcare providers in contact with COVID-19 positive individuals as well as the immediate family of those who are infected. 

Officials also stressed that people who’ve taken HCQ should still follow all safety protocols and not fall prey to a ‘false sense of security,’ as the drug does not guarantee complete protection from the virus.

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